Unfortunately, despite the availability of cutting-edge medical treatment, the health of individuals and populations continues to decline year over year. Over 90% of our patients have untreated metabolic syndrome, and over 80% have undiagnosed prediabetes or diabetes type 2.  The symptom of pain is the final common pathway for the human body to signal impending tissue damage, and most patients avoid contact with the health delivery system until they develop a symptom that they can no longer ignore. Unfortunately, our clinical practice is not unique. Pain is the leading reason for patients seeking medical care and is one of the most disabling, burdensome, and costly conditions in the US. Overall, pain care/treatment and lost productivity costs $635 billion per year. The commonality in metabolic syndrome and chronic pain is the hyperinflammatory state or metainflammation.

As we have treated this patient population over the last 20-plus years, we have discovered some common threads that trouble us.  About 80% of the patients have either obesity, prediabetes or diabetes, with the vast majority remaining undiagnosed.  More than half of these patients go on to have significant expensive complications and about 20% eventually require dialysis. By 2026, the Medicare system will be so overwhelmed with the diseases of metainflammation that it will literally run out of money.  We must engage individual patients in improved health outcomes in order to change the community.  We have fewer than seven years.

We are passionate about returning this patient population to health, and avoiding bariatric surgical procedures, which are costly and carry significant risks of organ injury, death, and long-term disability.  We have found that academic institutions avoid this population until extraordinary and expensive complications set in, requiring hospitalization.  It is our opinion that there is a fundamental cultural disconnect between the ivory tower of the institutions and the actual communities where these patients reside. This cultural disconnect prevents patient engagement in lifestyle changes.  Additionally, the Medicaid system does not reimburse for lifestyle and dietary modification for obesity but does reimburse for bariatric surgery. The overwhelming marketing from processed food manufacturers targets the urban minority communities with disingenuous messaging, suggesting health benefits for obesogenic foods.  This combined with supplemental nutrition benefits and game theory promotes the hyper-consumption of farmer-subsidized high fructose corn starch as well as industrial seed oils.  It is our opinion that the overconsumption of hyperpalatable, nutritionally deficient food is a major contributor to reduced academic success, reduced employment opportunities, increased incarceration rates, and progression of metabolic dysfunction.  It is a root cause of the social and economic disparity.